Effect of Sevoflurane–Nitrous Oxide Induction on the Incidence of Rocuronium Injection Pain in Adults

Objective: This randomized, prospective study was designed to investigate the effect of sevoflurane-nitrous oxide application on the incidence of the hand/arm withdrawal movement caused by rocuronium injection. Materials and Methods: There were 90 individuals undergoing elective surgery included in the study. After preoxygenation, Group T was given intravenous (i.v.) 5 mg/kg thiopental, Group S was given 7% sevoflurane and 40%/60% air/O2, and Group N was given 7% sevoflurane and 40%/60% N2O/O2 for induction. After the eyelash reflex was lost, 0.6 mg/kg rocuronium was applied intravenously over 5 seconds, and then 2 ml saline was administered. Patients' response to rocuronium injection was graded by using a 4-point scale (0-3). Hemodynamic data were recorded. Results: After the rocuronium injection, the mean arterial pressure (MAP) and heart rate (HR) values were different between the groups (p<0.05). The incidence of withdrawal movements associated with the injection of rocuronium was observed to be 96.7% in Group T (29/30), 73.3% in Group S (22/30), and 13.3% in Group N (4/30). There were significant differences between the groups (p<0.05). There were differences between Group T and Group S in terms of MAP and 4-point scale, and between Group N and Group S in terms of MAP, HR, and 4-point scale (p<0.05). Conclusions: Adding nitrous oxide to sevoflurane induction in adults reduces the incidence of withdrawal movements associated with rocuronium injection compared to thiopental induction.